Adrian Hugo Aginagalde
Spokesperson of the Spanish Society of Preventive Medicine, Public Health and Health Management (SEMPSPGS), Head of Service of the Epidemiological Surveillance and Health Information Unit of Gipuzkoa and, previously, Head of Service of the Population Screening Programmes Unit at the Ministry of Health
Before the start of vaccination, 10% of cases required hospitalisation; in the latest wave, 2.4%, and case fatality has dropped from 1% to 0.1%. In other words, vaccination and the Omicron have reduced the severity and measures need to be reassessed. Despite this, the healthcare impact of SARS-CoV-2 is still three times that of influenza and the percentage of hospitalisations in the over-60s is high. It therefore seems prudent to maintain the use of facemasks in health and social care settings.
On the other hand, transmissibility in schools has been low in the different series studied (less than 5%) and the percentage of hospitalisation has also been low (less than 0.5%), which would support the modification in educational centres. Socialisation spaces have been one of the main sites of transmission (with a secondary attack rate of more than 30 %) and it is necessary to introduce ventilation measures to reduce the risk, but given the high percentage of vaccination, and as long as the current hospital occupancy is maintained, it is to be expected that their withdrawal will be considered.
Perhaps the most complicated aspect to assess is that of workplaces, with a high transmissibility (secondary attack rate of over 15%), very different situations and people of more vulnerable ages. In these environments it is necessary to first establish measures to ensure ventilation, and then under what conditions the use of masks may be necessary, taking into account the distance between people, the number of people working in the same room and the environmental conditions. Probably in places with a high number of people and without the possibility of guaranteeing adequate ventilation, the use of masks to protect the worker's health should be considered.